Whether you are for or against the changes produced by the Affordable Care Act, Dr. Siegal says the system “just became a lot less stable.”
“The tacit, quid pro quo had been that lost revenue from Medicare would, at least in part, [be] offset when 30-plus million Americans with newly minted insurance plans became paying healthcare consumers,” Dr. Siegal adds. “With this delicate balance suddenly jeopardized, my guess is that many health systems will circle their wagons until they know which way the wind will blow.”
All told, the healthcare landscape remains one that is pockmarked by generational reform that will require deft hands to navigate. But those who are still fighting reform and its expanded access provision might be missing the larger point.
“You could repeal the Affordable Care Act today, which is not going to happen obviously, but it wouldn’t change the fact that these emerging alternative payment methodologies are still going to occur,” Dr. Siegal says. “It’s beyond Medicare. The private payors are doing it. Physician groups and hospitals and other integrated healthcare organizations are gearing up to take those payments … because staying in fee-for-service is untenable.”
Richard Quinn is a freelance writer in New Jersey.